Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Pe COMMUNITY MEC2011 -00080
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/23/2011
Parcel: 2S103CB02601
Jurisdiction: Tigard
Site address: 12185 SW MARION ST
Project: DELANO Subdivision: Lot: 0
Project Description: Gas furnace replacement.
Contractor: ABLE HEATING & COOLING Owner: DELANO, NELLIE M & GARY W
8900 SW BURNHAM F -5 12185 SW MARION ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE:
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/23/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/23/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/23/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Z
Issued By Permittee Signature:
L
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE l'SE ONLY
City of Tigard , Received 1
Dale/BY: O . �v 1 �� A it
e ° 13125 SW Hall BM., Tigard, OR 97223 3 Plan R ` ' plan Review
Phone: 503.639.4171 Fax 503,598.196k0 c. Date Re Other Permit.
Inspection Line: 503.639.4175 � :'.C
611 See Page 2 for
Internet www.tigard or. ov
r I C: t R P l $ , rs \ i c)� - \ u \ INC:\I )\o, Notif -Y ,h od: �7. Supplemental Information
`v ` r
TYPE OF W y COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction 21 Addition/alteration /replacement { Mechanical pentutfccs• arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: . mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION • Value: $ 52.00
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
tEl 1- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building
For special i use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/ceoling
]t Air conditioning
Job site address: 1'SW Marion St
(requires siteptan showing placement) 46.75
City/State/ZIP: Tigard, OR. 97223 Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg./apt no.: Project name: Delano Heat pump 61.06
Cross street/directions to job site: Duct work 23.32 ,
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
•
a..ea:.;ao., i,ot, Flue/vent for any of above • 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 2332
Gas fireplace 33.39
Replace existing Gas Furnace Flue vent for water heater or gas
fireplace 2332 _
Log lighter (gas) 23.32
Wood /pellet stove 3339
Wood fireplace/insert 23.32
® PROPERTY OWNER 1 ❑ TENANT Other. y/liner!fiue/vent 23.32
Oth 2332
Name: Gary and Nellie Delano Environmental exhaust and ventilation
Address: 12185 SW Marion St. Range hood /other kitchen
equipment 3339
City/StateJZIP: Tigard, OR. 91223 Clothes dryer exhaust 3339
Single -duct exhaust (bathrooms,
Phone: (503)590 -4652 Fax: ( ) toilet compartments, utility moms) 2332
❑ ArrUCAN`Y ❑ CONTACt' PERSON Attioebrswlapace fano 23.33
Business names: 23.32 L
Fuel piping
Contact name: 514.15 for first four; 54.03 for each additional
Furnace, etc. 1
Address: _ Gas heat pump I
City/State /ZIP: Wall/saspendedlunit heater
Phone: ( ) Fax:: ( ) Water heater
_
E -mail: Range
CONTRACTOR Barbecue
ceotxas atycc Cltl
Business name: Able Heating & Cooling, LLC.
Other:
Address: 8900 SW Burnham N F -5 MECHANICAL PERMIT FEES*
City /State/ZTP: Tigard, OR. 97223 Subtotal 46.75
Phone: (503) 579-2250 Fax: (503) 620 -3980 Minimum permit fee ($90.00) 90.00
_. ... Plan review (25 %ofnemait feel
I CCB tic.: 184392 1 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been ancepted as complete.
I Print name: Kelly W' i ' Date: 412 - - 2010 -- ] • Fee methadolon' sat byTri -County Building Industry Service Board
I. ' d O86£-OZ9 -£09 - -- 11 6u!loo0 , g 6u!iueH e civ